CAR-T(CAR-T)细胞疗法在非肿瘤性疾病中的应用
Chimeric antigen receptor T (CAR-T) cell therapy in non-oncological diseases.
CAR-T(CAR-T)细胞在血液系统恶性肿瘤中的应用推动了这种免疫治疗形式的显著进展。
CELL INTELLIGENCE · 肿瘤细胞治疗研究
肿瘤细胞治疗研究
英文原题:Leveraging the Immunomodulatory Potential of Ibrutinib for Improved Outcomes of T Cell-Mediated Therapies of B Cell Malignancies: A Narrative Review.
Leveraging the Immunomodulatory Potential of Ibrutinib for Improved Outcomes of T Cell-Mediated Therapies of B Cell Malignancies: A Narrative Review.
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B细胞恶性肿瘤的标准治疗方案包括免疫化疗和/或靶向治疗,这些方法常能提供暂时的疾病缓解。然而,许多患者通过这些治疗未能达到完全缓解,产生耐药性,并最终经历疾病复发。新型免疫调节治疗,如基于T细胞的疗法,在治疗包括B细胞恶性肿瘤在内的多种血液癌症方面显示出前景。然而,其疗效常受限于免疫抑制性肿瘤微环境和患者来源T细胞的功能改变。伊布替尼,一种布鲁顿酪氨酸激酶抑制剂,已被证明能恢复慢性淋巴细胞白血病患者的免疫平衡和功能。伊布替尼正在被研究作为嵌合抗原受体(CAR)T细胞或T细胞衔接双特异性抗体的辅助或联合疗法,用于治疗B细胞恶性肿瘤。当前证据表明,伊布替尼在CAR-T 细胞给药前、期间或后使用可能有益,可能提供更高的完全缓解率和降低的毒性。总之,现有证据强烈支持伊布替尼与T细胞疗法的联合使用。然而,仍需额外的临床试验来进一步验证该治疗策略在各类B细胞恶性肿瘤患者中的有效性。
Standard treatment options for B cell malignancies include immunochemotherapies and/or targeted therapies, which often provide temporary disease remission.
However, many patients do not achieve complete remission with these treatments, develop resistance, and eventually experience disease relapse. New immunomodulatory treatments, such as T cell-based therapies, show promise in treating various types of blood cancers, including B cell malignancies.
However, their effectiveness is often limited by the immunosuppressive tumor microenvironment and altered function of patient-derived T cells. Ibrutinib, a Bruton tyrosine kinase inhibitor, has been shown to restore immune balance and function in patients with chronic lymphocytic leukemia.
Ibrutinib is being studied as adjuvant or combinatorial therapy with chimeric antigen receptor (CAR) T cells or T cell-engaging bispecific antibodies for the treatment of B cell malignancies. Current evidence suggests that ibrutinib could be beneficial when used before, during, or after CAR T cell administration, potentially providing higher complete response rates and reduced toxicity.
In conclusion, existing evidence strongly supports the combined use of ibrutinib and T cell therapies.
However, additional clinical trials are needed to further validate the effectiveness of this treatment strategy in patients with various B cell malignancies.
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